Communicating to Improve the Quality of Informal Care

描述（由申请人提供）：初级保健提供者看到越来越多的老年人，其中许多人患有慢性疾病，涉及多种药物和复杂的治疗方案。这种护理大部分是由家庭成员（非正式照顾者）提供的，他们经常陪同老年患者去看医生。与护理三方（如老年患者、非正式护理人员和提供者）的沟通对所有相关人员都是挑战。大多数提供者没有正式的指导来培养三合一沟通的技能，然而，清晰有效的沟通对于确保准确和充分地遵守治疗方案至关重要。该项目将为初级保健提供者开发和评估一个基于网络的继续教育（CME/CE认证）项目，以发展/提高与护理三方有效沟通的技能。该计划的目标是医生和护士，尽管它将非常相关的任何卫生保健专业人员参与照顾老年人。第一阶段的具体目标是：1)为整个项目制定一个内容大纲；2)开发网络程序的设计和格式；3)开发一个程序模块的脚本和故事板；4)在Web上开发该模块（原型）；5)对样机进行可行性评估；6)为第二阶段的完整课程和CME/CE认证制定计划和时间表。

DESCRIPTION (provided by applicant): Primary care providers are seeing increasing numbers of older adults, many of whom have chronic conditions that involve multiple medications and complex treatment regimens. The majority of this care is provided by family members (informal caregivers) who often accompany the older patient to the provider visit. Communication with a care triad (e.g., older patient, informal caregiver, and provider) presents challenges to all involved. Most providers have no formalized instruction to develop skills in triadic communication, yet clear and effective communication is critical to ensuring accurate and adequate adherence to a treatment regimen. This project will develop and evaluate a Web-based, continuing education (CME/CE accredited) program for primary care providers to develop/enhance skills for effective communication with care triads. The program targets physicians and nurses, although it will be extremely relevant to any health care professional involved in the care of older adults. The Specific Aims of Phase I are to: 1) develop a content outline for the full program; 2) develop the design and format of the Web-based program; 3) develop a script and storyboard for one program module; 4) develop this module (prototype) on the Web; 5) conduct a feasibility evaluation of the prototype; and 6) develop a plan and schedule for production of the full-length program and CME/CE accreditation in Phase II. This project directly extends the investigative team's research on physician communication with older patients (AG15248; AG23366). Primary care providers have responsibility for clear and effective communication with patients. In the case of these caregiving dyads, they also have an opportunity to support informal caregivers in a way that can enhance treatment adherence and improve health care outcomes. This project involves the close collaboration of NERI, the Boston University School of Medicine, and the Harvard School of Public Health. The Web-based program will be marketed as a CME/CE product for primary care physicians and nurses through NERI's e-commerce website and also through the Boston University School of Medicine Office of Continuing Medical Education. The main outcome in the Phase I feasibility test (N=80) will be change in knowledge from baseline to endpoint. In addition, detailed questions about accessibility, usability, and satisfaction with content will be asked. Phase I feasibility will be demonstrated if 1) there is a gain in knowledge for a majority of participants (physicians, nurses), and 2) at least 75% of the sample report satisfaction (satisfied or very satisfied) with the content, access, and usability of the prototype.